MEDICARE: MRS. JODI L. LANCASTER MA CCCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	A00759	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45-00027	OTHER	OH	UNITED HEALTHCARE
2	341713667027	OTHER	OH	CARESOURCE
3	61248	OTHER	OH	QUALCHOICE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000137222	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1518952191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JODI L. LANCASTER MA CCCA

Provider Business Mailing Address
First Line	:	157 W CEDAR ST
Second Line	:	STE 106
City	:	AKRON
State	:	OH
Zip	:	44307-2551
Country	:	US
Telephone Number	:	330-376-1221
Fax Number	:	330-376-3953

Provider Business Practice Location Address
First Line	:	157 W CEDAR ST
Second Line	:	STE 106
City	:	AKRON
State	:	OH
Zip	:	44307-2564
Country	:	US
Telephone Number	:	330-376-1221
Fax Number	:	330-376-3953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/08/2007

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